Job description
Job description
This position is responsible for auditing medical bills for accurate adjudication of fee schedule, usual and customary, and PPO payment recommendations. It is also responsible for ensuring client contractual requirements and IMS company policies are met. Must have at least 3 years experience in both: the workers compensation industry and medical bill review
Responsibilities
- Utilize fee schedules, usual and customary databases, national bill payment standards, bill repricing reference materials, client instructions, and IMS training materials to effectively audit medical bills
- Audit supporting documentation provided with medical bills to ensure bills are properly adjudicated
- Proactively learn and administer new fee schedules, state regulations, national repricing standards and client requirements
- Research system repricing and performance issues and submit examples to the IT Department for resolution
- Provide system and staff performance recommendations or issues to management
- Provide feedback to the Training Department to improve employee performance
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: In person
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